RaleighRecruiter Since 2001
the smart solution for Raleigh jobs

Director State Regulatory Affairs - Raleigh

Company: Wellcare Health Plans
Location: Raleigh
Posted on: November 11, 2019

Job Description:

LOCATION: Raleigh, NCDEPARTMENT: StateREPORTING TO: State President - NCIncumbent leads the State Regulatory Affairs department and responsible for developing and executing the Medicaid Regulatory Affairs strategy, focused on publicly funded healthcare programs. Provides guidance, oversight and support to Regulatory Affairs teams with respect to contract administration and account management. Provides strategic guidance from a regulatory perspective to the market leader, COO and/or leadership team. Partners with state Medicaid agency to ensure compliance and effective partnership.Essential Functions:Identifies, compiles and aggregates regulatory and operational issues across markets to manage risk. Partners with markets on resolutions through expertise and lessons learned.Makes timely and effective decisions using data and takes a fact-based approach to problem-solving, while understanding the limits of data to make and support decisions.Establishes the Medicaid Regulatory Affairs strategy and oversees contract administration activities in markets.Manages and supports audits and implementations to ensure regulatory requirements are satisfied.In partnership with Corporate Compliance, develops procedures, toolkits and reports and monitors contractually required deliverables, including but not limited to, regulatory reports and performance metrics.Develops procedures and toolkits for Account Management Plans and monitors adherence with corporate processes.Directs and manages a team of associates responsible for supporting Medicaid Regulatory Affairs initiatives and teams.Supports development and implementation of Regulatory Affairs in new markets.Develops and manages department budget.Performs special projects as needed.Candidate Education:Required A Bachelor's Degree in business administration or related fieldPreferred A Master's Degree in public policy, public health, political science, health administration or related field Candidate Experience:Required 10 years of experience in managed health care or health care consultingRequired 5 years of management experience Candidate Skills:Intermediate Demonstrated leadership skillsIntermediate Ability to lead/manage othersIntermediate Other facilitative skillsIntermediate Other In-depth knowledge of government programs and the managed care industry and experience leading and managing regulatory affairs programs through teamwork, collaboration and open communication Licenses and Certifications:A license in one of the following is required:Technical Skills:Required Intermediate Microsoft Project Strong knowledge of MS Office including Project, Access, PowerPoint and VisioRequired Intermediate Microsoft Access Knowledge of and/or ability to utilize COGNOS for budgetary decisions or reviewRequired Intermediate Microsoft PowerPointRequired Intermediate Microsoft VisioRequired Intermediate Other Knowledge of and/or ability to utilize COGNOS for budgetary decisions or review Languages:About usHeadquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.

Keywords: Wellcare Health Plans, Raleigh , Director State Regulatory Affairs - Raleigh, Executive , Raleigh, North Carolina

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Senior Manager - Corporate Strategy
Description: Job ID : 78740 br br Location: USA-NC-Raleigh br br Functional Area: Strategy and Operations br br Facility: Corporate Office br br Relocation Provided: Yes br br Education (more...)
Company: Lenovo
Location: Raleigh
Posted on: 11/14/2019

Director, Software Engineering
Description: OUR CUSTOMERS DEVELOP SOFTWARE AT THE SPEED OF IDEASCloudBees is powering the continuous economy by offering the world's first end-to-end continuous software delivery management system SDM . For millions (more...)
Company: CloudBees
Location: Raleigh
Posted on: 11/14/2019

Project Manager
Description: Independently manage projects, including work with internal and external project teams to help develop and maintain timelines, track deliverables to meet milestones, coordinate meetings, track metrics, (more...)
Company: Tergus Pharma
Location: Raleigh
Posted on: 11/14/2019


Director, Quality Control
Description: The Director, Quality Control will be responsible for the organization and administration of all quality control functions of the Cellectis Raleigh facility, including ensuring that the company's products (more...)
Company: Cellectis
Location: Raleigh
Posted on: 11/14/2019

Accounting Manager
Description: Career Foundations is recruting for an Accounting Manager with a 1B client in RTP. The -position will be responsible for the oversight of several functional areas such as: Accounts Receivable, Accounts (more...)
Company: career foundations inc
Location: Raleigh
Posted on: 11/14/2019

Relationship Manager I Small Business Administration - SBA
Description: Position Overview br br At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. (more...)
Company: PNC Financial Services Group
Location: Raleigh
Posted on: 11/14/2019

Tax Manager
Description: Tax Managerjob details: ul li location:Raleigh, NC li salary: 90,000 - 110,000 per year li date posted:Thursday, October 31, 2019 li experience:7 Years li job type:Permanent
Company: Randstad
Location: Raleigh
Posted on: 11/14/2019

Project Manager
Description: RESPONSIBILITIES:Kforce has a client in search of a Project Manager in Raleigh, North Carolina NC .Essential Functions: Assembles project plans and teamwork assignments, directs and monitors work efforts (more...)
Company: Kforce Technology Staffing
Location: Raleigh
Posted on: 11/14/2019

Assistant Project Manager/MEP Engineer
Description: Job ID br br 7393 br br of Openings br br 1 br br Job Location br br US-NC-Raleigh br br Category br br Construction br br Relocation Assistance br br Yes br br (more...)
Company: Dewberry Engineers Incorporated
Location: Raleigh
Posted on: 11/14/2019

Senior Sales Manager, Acquisition
Description: FreshBooks has a big vision. We launched in 2003 but we're just getting started and there's a lot left to do. We're a high performing team working towards a common goal: building an extraordinary online (more...)
Company: FreshBooks
Location: Raleigh
Posted on: 11/14/2019

Log In or Create An Account

Get the latest North Carolina jobs by following @recnetNC on Twitter!

Raleigh RSS job feeds